Republicans Step Up Attacks on Health-Care Law

One day after a Florida judge ruled the Affordable Care Act’s individual mandate is unconstitutional, Senate Republicans kept pushing to combat the law in the legislative branch.

After the GOP’s weekly lunch, Sen. Mitch McConnell, the minority leader, told reporters in the Capitol that he would tack an amendment to repeal the health-care law onto an aviation re-authorization bill under consideration in the chamber today. Democratic leader Harry Reid said the vote could come as early as today, though aides say it could also come tomorrow. “We will get a vote, one way or the other,” says Republican Sen. Lamar Alexander of Tennessee. Alexander said whether or not it comes in a straight up-or-down form, the vote “is going to show who’s for repeal and who’s not.”

With a few exceptions, we already know where the players stand. All 47 Republican Senators have signed onto the repeal effort. And while Republicans may be able to peel off a stray Democrat or two, the GOP has little chance of getting to the 60-vote threshold needed for passage. Still, Senate Republicans are making the same calculation as their colleagues in the House. They see health-care repeal as a political winner, and after months and months of beating the drum, they want to be on the record as pressing for it, even if the gesture is largely symbolic.

McConnell’s move wasn’t even the GOP’s first attempt of the afternoon to bring down health-care reform. At an earlier press conference, Republican Sens. Lindsey Graham and John Barrasso unveiled a bill that would allow states to opt out of the PPACA’s keystone provisions, including the individual and employer mandates and the requirement that states expand their Medicaid programs. “We’re opening up a third front” against the law, Graham explained. (The court challenges and House repeal bills are the first two.)

Of course, states can already opt out, provided they satisfy certain conditions, and get waivers to develop their own plans. The authors’ wrapped their proposal in states-rights rhetoric, but by their own admission, the Graham-Barrasso effort, titled “The State Health Care Choice Act,” was less about giving states the power to tailor their own solutions under the framework of the existing law than spurring them to opt out, thereby driving up costs and forcing the system to collapse. Ostensibly, this would necessitate a replacement measure more palatable to Republicans. “If you take half the states out of the individual mandate, [the PPACA] falls,” Graham said. “Quite frankly, that’s the goal.” He said the party intended to replace it with measures that expands coverage and lowers costs, but neither he nor his colleagues have explained how they would do so.

Democrats will offer a budget point of order against the repeal amendment, invoking the CBO’s estimate that health-care repeal would increase the deficit. But Senate Democratic leaders, who have been stressing the law’s popular components in an attempt to galvanize support as new provisions take effect, say the vote will go forward. “We want to get this out of their system quickly,” Reid said.

That doesn’t seem likely. Confident that keying on the issue will boost their chances in 2012, Republicans appear intent on continuing their multi-pronged challenge to the PPACA—not just in the legislative branch, where the issue is heading toward the Supreme Court, but with go-nowhere opt-out measures and repeal votes that fulfill campaign promises but don’t have much practical impact. Barrasso spoke of “[taking] the fight from Washington to the states,” where the GOP could bludgeon Democrats with the health-care issue in campaigns across the country. Assuming they’ll shift from this strategy seems, for the moment, like wishful thinking.